Objective:

To analyze cancer screening adherence among sexual orientation and gender identity minority groups using Behavioral Risk Factor Surveillance System data.

Approach:

• Data Source: Analysis of 2018 to 2022 Behavioral Risk Factor Surveillance System data from selected US states.
• Study Population: 663,924 unweighted screening-eligible adult respondents with available sexual orientation or gender identity data.
• Eligibility Criteria: Defined according to US Preventive Services Task Force recommendations for colorectal, cervical, and breast cancer screening.
• Screening Definitions: Self-reported adherence to screening guidelines for colorectal, cervical, and breast cancer.
• Statistical Analysis: Survey-weighted Poisson regression models adjusted for demographic, socioeconomic, and health care access factors.

Key Findings:

• Sexual orientation minority women reported lower adherence to cervical (adjusted prevalence ratio 0.92) and breast cancer screening (adjusted prevalence ratio 0.84) compared to heterosexual women.
• Colorectal cancer screening adherence did not differ by sexual orientation among women.
• Gender identity minority respondents had lower adherence to cervical (adjusted prevalence ratio 0.58) and breast cancer screening (adjusted prevalence ratio 0.24) compared to cisgender respondents.
• Female-to-male transgender respondents showed lower adherence to colorectal and cervical cancer screening compared to cisgender female respondents.
• An 8.3-percentage-point adherence gap in cervical cancer screening was identified between sexual orientation minority and heterosexual women.

Interpretation:

The study highlights persistent disparities in cancer screening adherence among sexual orientation and gender identity minority groups, with significant gaps particularly in cervical and breast cancer screenings.

Limitations:

• Cross-sectional design and self-reported data may introduce bias.
• Potential misclassification of sexual orientation and gender identity.
• Non-representative sample due to optional modules and low response rates.
• Lack of data on medical or surgical transition and hormone therapy use.

Conclusion:

The findings indicate ongoing disparities in cancer screening adherence among sexual orientation and gender identity minority respondents.

Sources:

• Cancer